Axial Projection Research Articles

Study of neuromuscular activity in preparation for revision knee arthroplasty

The results of an electromyographic study of 13 patients, aged 50–87 years, with aseptic instability of the components of a knee joint endoprosthesis at the stage of preparation for revision arthroplasty, who were treated at the Republican Scientific and Practical Center of Trauma tology and Orthopedics in the period from 2013 to 2020, were analyzed. To assess the orthopedic status, we used: clinical examination, radiography of the knee joint in 2 standard and axial projections, topogram and CT scan. lectrophysiological studies provide important information for elucidating the etiopathogenesis of knee joint endoprosthesis instability. One of the causes of instability may be an imbalance in the activity of the flexor and extensor muscles that develops during walking, subsequently leading to periprosthetic osteolysis, which occurs as a response to the formation of wear and tear products of the components of the endoprosthesis.

Anatomical Features and Morphometric Characteristics of the Sphenoidal Sinus in MRI Studies.

Differential access to pathological sellar processes and adjacent regions is determined by the anatomic structures identified through diagnostic imaging. Both direct endonasal access (microscopic or endoscopic) and sublabial access utilize the sphenoid sinus (SS) as the primary surgical pathway. Critical factors include the pneumatization of the sinus, its intermediate septa, and the presence of a double wall, consisting of a connective tissue membrane along the dorsal wall of the SS. The present study aims to demonstrate the significance of the size and type of the SS based on MRI measurements. The type of SS, its pneumatization, and the proximity of adjacent brain structures are crucial for different surgical approaches to the SS and pituitary fossa. In neurosurgical practice, six main types of sinuses are recognized: sphenoid body type, lateral type, clival type, lesser wing type, anterior type, and combined type. Failure to consider these variations can lead to damage to the cavernous sinus, Meckel's cave, nerve structures in the middle cranial fossa, planum sphenoidale, suprasellar region, and vital brainstem structures located on the clivus. Randomly included MRI measurements were conducted on 112 patients from Pulmed University Hospital, Plovdiv, Bulgaria, categorized into two cohorts based on gender, with mean ages of 51 years for men and 47.8 years for women. The measurements, recorded in centimeters, were obtained using two imaging software programs, RadiAnt DICOM Viewer (Medixant, Poznan, Poland) and Weasis DICOM Viewer (Nicolas Roduit, https://github.com/nroduit/Weasis). No statistically significant differences were observed between the measurements produced by the two programs. Measurements of the SS were taken in two equal groups, using three different projections: axial, sagittal, and coronal. The results for height, width, and depth showed average sizes of 2.73-3.04 cm in axial projections, 1.70-2.64 cm in sagittal projections, and 2.86-3.03 cm in coronal projections. The minor differences between axial and coronal measurements of the same parameters (height and width) are statistically acceptable and attributed to the varying angles of the MRI scans. These measurements are crucial for planning surgical access to the sellar and parasellar regions, determining the necessary bony resection of the posterior wall of the SS, and preventing complications from excessive bony trepanation.

Multiplane reconstruction modifies the diagnostic performance of CT angiography in carotid webs

IntroductionCarotid Web (CaW) represents an overlooked stroke etiology and has been associated with high recurrence rates and to be amenable to stenting. We evaluated the diagnostic performance of different computed tomography angiography (CTA) projections in CaW. MethodsConsecutive patients <65 years-old with symptomatic CaW (n=31), carotid atherosclerosis (n=27), or normal carotids (n=49) diagnosed with a thin-cut CTA were included. Deidentified CTAs were independently reviewed by three readers, who recorded the diagnosis and level of certainty after evaluating the axial plane alone, after adding sagittal/coronal maximum intensity projection (MIP), then after oblique MPR reformats. ResultsThere were 93 total CaW, 81 atherosclerosis, and 147 normal carotid reads. With CTA axial projection alone, less CaW cases (44.1 %) were appropriately diagnosed as compared to atherosclerosis (87.7 %; p<0.001) and normal carotid (83 %; p<0.001) cases. Sagittal/coronal MIPS increased the rate of accurate CaW diagnosis (44.1–76.3 %; p<0.001). Inter-rater agreement in CaW detection increased from k= 0.46 (0.35–0.57) using axial to k= 0.80 (0.69–0.91) with sagittal/coronal planes. The axial projection alone had lower sensitivity (44 % vs. 76 %) but similar specificity (95 % vs. 96 %) in CaW detection compared to axial+ sagittal/coronal MIPS. The accuracy in detecting atherosclerosis or normal carotids did not increase after adding sagittal/coronal MIPS and oblique MPRs. The certainty level for CaW diagnosis was lower when compared to atherosclerosis and normal carotids using axial alone (3.0 [3.0–4.0] vs. 4.0 [3.0–5.0]; p<0.001 and 4.0 [3.0–5.0]; p<0.001) as well as after adding sagittal/coronal MIPS (4.0 [3.0–5.0] vs. 5.0[4.0–5.0]; p=0.01 and 4.0 [4.0–5.0]; p<0.001). ConclusionCTA axial plane alone was insufficient for CaW detection. CTA sagittal/coronal MIP reconstructions as well as oblique MPR reformats enhanced the accuracy and confidence related to CaW diagnosis.

No code machine learning: validating the approach on use-case for classifying clavicle fractures

PurposeWe created an infrastructure for no code machine learning (NML) platform for non-programming physicians to create NML model. We tested the platform by creating an NML model for classifying radiographs for the presence and absence of clavicle fractures. MethodsOur IRB-approved retrospective study included 4135 clavicle radiographs from 2039 patients (mean age 52 ± 20 years, F:M 1022:1017) from 13 hospitals. Each patient had two-view clavicle radiographs with axial and anterior-posterior projections. The positive radiographs had either displaced or non-displaced clavicle fractures. We configured the NML platform to automatically retrieve the eligible exams using the series' unique identification from the hospital virtual network archive via web access to DICOM Objects. The platform trained a model until the validation loss plateaus. Once the testing was complete, the platform provided the receiver operating characteristics curve and confusion matrix for estimating sensitivity, specificity, and accuracy. ResultsThe NML platform successfully retrieved 3917 radiographs (3917/4135, 94.7 %) and parsed them for creating a ML classifier with 2151 radiographs in the training, 100 radiographs for validation, and 1666 radiographs in testing datasets (772 radiographs with clavicle fracture, 894 without clavicle fracture). The network identified clavicle fracture with 90 % sensitivity, 87 % specificity, and 88 % accuracy with AUC of 0.95 (confidence interval 0.94–0.96). ConclusionA NML platform can help physicians create and test machine learning models from multicenter imaging datasets such as the one in our study for classifying radiographs based on the presence of clavicle fracture.

Radiology diagnostics of spinal corel injury in early children: a prospective study

INTRODUCTION: Spinal cord injury (SCI) in young children includes a relatively higher prevalence of cervical spine injury, multiple thoracic vertebral compression fractures, and spinal cord injury. Spinal cord injuries without radiological changes/signs of fractures or dislocations (SCIWORA) also occur in young children. X-ray assessment of damage to immature vertebrae and cartilage in young children is difficult, since incompletely formed vertebral bodies can be confused with fractures. Accordingly, an MRI is required, which provides a detailed anatomical image of all structures of the spinal column and also diagnoses damage to the spinal cord, ligaments and muscles.OBJECTIVE: To investigate the possibilities of methods of radiation diagnosis of spinal cord injury in young children (up to 3 years).MATERIAL AND METHODS: 20 children aged from 11 months up to 3 years old were studied with spinal cord injury. X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were performed. The standard MRI protocol for SCI in children under 3 years of age included: MR myelography in the coronary and sagittal projections, sagittal projection STIR, DTI and T2WI FS SE, axial projection T2WI FS SE or T2*WI FS GE; coronary projection T2WI SE; 3D T1WI FS GE before and after contrast enhancement.RESULTS: An analysis of the data of patients included in the category of polytrauma was carried out. The causes of SCI in these patients were road accidents and falls from various heights. X-ray and CT scans were uninformative, and had large discrepancies with MRI results. All anatomical and morphological changes revealed by MRI correlated well with clinical manifestations and corresponded to the classification of the level and severity of spinal cord injury (ASIA). An increase in the volume and change in the signal of the spinal cord due to edema and / or hemorrhage in the spinal cord is the main sign of damage to the spinal cord, and is best indicated on T2WI and STIR, as a hyperintense signal.DISCUSSION: MRI is critical in the emergency assessment of spinal cord injury or compression to predict the outcome of SCI. There is currently no spinal cord imaging technique that can compete with MRI. Increased volume and signal changes in the spinal cord due to edema and/or hemorrhage are a sign of spinal cord injury and are best demonstrated on T2WI and STIR as a hyperintense signal. Incomplete spinal cord injury is also manifested by a hyperintense signal on T2WI and/or FLAIR, which in intensity and extent correlates with the degree of injury. Hemorrhagic injuries are better detected using T2*GRE or SWI, and spinal cord edema is better detected using T2WI SE and STIR. In addition, STIR can identify bone marrow edema in injured vertebrae, even when the injury is not detected on CT.CONCLUSION: When performing MRI in patients with SCI, three quantitative parameters should be assessed: the maximum damage to the spinal cord, the maximum compression of the spinal cord, and the length of the affected area. In addition to the results of quantitative parameters, potential predictive qualitative MRI findings should be evaluated such as intramedullary hemorrhage, focal and diffuse spinal cord edema, soft tissue injury, probable stenosis before injury, and disc herniation.

Experimental study on fragments dispersion characteristics of elliptical cross-section casing under explosive loading

To better understand the fragments dispersion characteristics of elliptical cross-section warhead (ECSW), static explosion experiments were conducted with four ECSWs and one circular cross-section warhead (CCSW). The warheads were designed with the same mass ratio of charge to the metal casing, and the difference in cross-section shape was indicated by the shape ratio. The experimental results indicated that ECSW fragments dispersion in their radial direction deviated from the normal direction of casing under explosive loading. The radial deviation angle decreased with the higher shape ratios. In the axial direction, the axial projection angle of fragment increased gradually from the major to the minor axis. Additionally, the fragment velocity and density in the minor axis direction increased noticeably compared to the major axis, and the difference reduced as the shape ratio increased. A formula for predicting the radial velocity distribution of the fragments was proposed, and the maximum relative error between the calculation and experiment results is less than 5 %. Finally, the driving mechanism of ECSW was preliminarily revealed. The findings serve as a fundamental basis for future research on ECSW and offer valuable insights for the development of innovative warhead designs.

Radiography of OS Calcaneus with Spur Study Formation at Columbia Asia Hospital Medan

Radiographic examination of the calcaneus bone using X-rays can clearly determine the location of the spur formation. The aim of this study was to determine the procedure for carrying out Os Calcaneus radiography with suspected spur formation at Columbia Asia Hospital, Medan. The type of examination used is descriptive qualitative. Data collection techniques are based on the results of literature reviews, interviews, observations and documentation. This examination was carried out at Columbia Asia Hospital Medan, in January 2020, using a General X-ray unit x-ray, 18 cm x 24 cm cassette, with image processing using Computed Radiography. The results of the research obtained radiographic images of the calcaneus bone with greater detail and sharpness, so that it could show spur formation on the calcaneus bone. To show the anatomical picture and pathological abnormalities in the Os Calcaneus with suspected spur formation, it can be done using Axial and Lateral projections.

Radiography Cervical Vertebrae with Suspect Spodylosis at the Prof. Dr Chairuddin Panusunan Lubis Educational Hospital University of North Sumatra Medan

The cervical vertebrae (neck bones) are vertebrae which consist of seven segments which have small segment bodies and large segment openings. Radiographic techniques are the science of studying procedures for photographing objects that are examined using X-rays. Cervical spondylosis is a common degenerative disease of the cervical spine. To show abnormalities in these organs, X-rays in the field of radiology are needed. Therefore, a radiological examination is needed to show whether there is spondylosis and its effect on the surrounding organs. with AP Axial and Lateral examination techniques. The AP Axial projection shows an image of the cervical spine from the AP position. Lateral projection shows an image of the cervical vertebrae from a lateral position, and spondylosis is clearly visible at C3 and C4. In collecting data, the author used interviews and field observations. The results of the diagnostic examination provided information about abnormalities in the cervical spine using Computer Radiography (CR), a cassette measuring 24 cm x 30 cm with a device used by Philips with a capacity of 500 mA.

Analysis on Hydraulic Design of Runner Blades of Francis Turbine

Francis turbine is the most widely used model in hydropower station, and the hydraulic design of runner blades affects the efficiency of the unit. This paper discusses how to complete the hydraulic design of Francis turbine runner blades according to the given parameters. In hydraulic design of Francis turbine runner, firstly, the structural scheme is determined according to the given parameters. On the basis of referring to excellent hydraulic model, a Francis turbine runner blade is designed according to the given head. By analyzing and calculating the data, the geometric parameters and axial projection of the Francis turbine runner flow channel are determined, and the axial flow network is drawn and checked, so as to complete the calculation of axial vortex line and blade drawing. Finally, the airfoil is thickened by a certain thickening principle.

Clinical and radiologic outcomes of Lima ProMade custom 3D-printed glenoid components in primary and revision reverse total shoulder arthroplasty with severe glenoid bone loss: a minimum 2-year follow-up.

The purpose of this study is to report the clinical and radiologic outcomes of patients undergoing primary or revision reverse total shoulder arthroplasty using custom 3D-printed components to manage severe glenoid bone loss with a minimum of 2-year follow-up. Following ethical approval, patients were identified and invited to participate. Inclusion criteria were (1) severe glenoid bone loss necessitating the need for custom implants and (2) patients with definitive glenoid and humeral components implanted more than 2 years prior. Included patients underwent clinical assessment using the Oxford Shoulder Score (OSS), Constant-Murley score, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and the quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH). Radiographic assessment included anteroposterior and axial projections. Patients were invited to attend a computed tomography (CT) scan to confirm osseointegration. Statistical analysis used descriptive statistics (mean and standard deviation [SD]) and paired t test for parametric data. Eleven patients declined to participate. Five patients were deceased prior to study commencement, leaving 42 remaining patients in this analysis. Three patients had revision surgery before the 2-year follow-up; of these, 2 retained their custom glenoid components. Mean follow-up was 31.6 months from surgery (range 24-52 months). All 4 scores improved: OSS from a mean 15 (SD8.4) to 36 (SD12) (P<.001), Constant-Murley score from a mean 15 (SD11.2) to 52 (SD20.1) (P<.001), QuickDASH from a mean 70 (SD21) to 31 (SD24.8) (P=.004), and the ASES score from a mean 22 (SD17.8) to 71 (SD23.3) (P=.007). Radiologic evaluation demonstrated good osseointegration in all but 1 included patient. The utility of custom 3D-printed components for managing severe glenoid bone loss in primary and revision reverse total shoulder arthroplasty yields significant clinical improvements in this complex cohort. Large complex glenoid bone defects can be managed successfully with custom 3D-printed glenoid components.

THE RESULTS OF SEPTOPLASTY IN PATIENTS WITH VARIOUS FORMS OF DEVIATED OF THE NASAL SEPTUM USING THE TECHNIQUE OF EXTRACORPOREAL REMODELING AND REPLANTATION OF THE SEPTUM

Objective: To present the results of extracorporeal septoplasty in patients with various forms of deviated of the nasal septum, using the technique of replantation of the septum and to discuss the advantages and limitations. Materials and methods: The work is based on clinical observations of 164 patients with curvature of the nasal septum from 2018 to 2023. All patients underwent a standard otorhinolaryngological examination, spiral computed tomography CT of the nose and paranasal sinuses in coronary and axial projections. Endoscopic examination of the nasal cavity carried out by an endoscope of the Karl Storz company. Nasal breathing is objectively evaluated with the help of the "PC 300 nose manometer" by ATMOS, which allows to register the pressure in one half of the nose while the patient breathes through the other. A modified "extracorporeal" septoplasty is used, which consists in the complete isolation and temporary removal of the deformed quadrilateral cartilage, followed by its correction and reimplantation. The operation was performed under general anesthesia with performed oral intubation. Results: No complications were observed during the operation, the patients were satisfied with the aesthetic and functional results of septoplasty. Complications were noted in the remote postoperative period. long-term swelling of the mucous membrane of the nose (partially obstructed nasal breathing), which was stopped by taking antihistamines, in 5 patients. In all clinical observations, stable support of the cartilaginous part of the nasal septum and the absence of its secondary deviation were obtained, which also directly affects the harmonic aesthetic results of the shape of the external nose and free nasal breathing. The indicators of the rhinomanometer showed a significant improvement in nasal breathing and are approaching the values accepted as the norm. Conclusions: Extracorporeal septoplasty in patients with various forms of curvature of the nasal septum is an effective surgical technique that gives optimal functional results.

Patellofemoral pain syndrome assessed by Lysholm score, radiological and biorheometric measurements

IntroductionThe aim of In this study was to verify the relationship among clinical indicators of patellofemoral pain syndrome (PFPS) and the results of modifying radiological investigation. Previous research suggests that there is a poor association between them. Therefore we have employed a technique for the functional evaluation of PFPS based on measuring the stiffness of the knee joint during passive flexion (biorheometry). MethodThe correlation between clinical examination and a standardized Lysholm score, radiological and biorheometric measures was investigated in the 28 knee joints of 14 subjects exhibiting clinical features of PFPS. A modified axial radiological projection of the patellofemoral articulation in 90° of flexion provided the parameters quantifying the anatomical - morphological arrangement of the patellofemoral joint. The biorheometric properties of the knee were evaluated using a custom made measuring apparatus during passive flexion and extension of the knee. ResultsOur results confirm that the link between the clinical findings and the X-ray imaging examinations was not evident. On the contrary, the biorheometric examination proved to correlate well with the clinical symptoms of PFPS. Parameters were identified which can characterize the biorheograms of people suffering PFPS. ConclusionsAnalysis of the relationship among the clinical, radiological and biorheometric examinations leads to the recommendation that biorheometric examination is an effective method for the objective assessment of PFPS.

Structural Limits of Orbital Compliance and Treatment Options for Pathologic Orbital Pressure.

The integrity of the orbit has a finite structural limit due to the compliance of its tissue. The authors investigate these limits to quantify them and inform the treatment of heightened ocular and orbital pressure. Cadaveric study with 12 orbits being volumized before randomization of treatment for pathologic levels of ocular and orbital pressure. First-line and second-line treatment was chosen randomly (lateral cantholysis, superior septolysis, inferior septolysis). Prior to treatment, IOP, orbital compartment pressure, and axial globe projection was measured after delivery of each 1cc aliquot and surgical treatment. Orbital compartment pressure and IOP were well correlated (r = 0.99). The average reduction in IOP after treatment averaged a 56.2 mm Hg reduction in IOP. All treatments were statistically equivalent ( p < 0.01). Loss of compliance (P LOC ) was determined when the mean plus 1 standard deviation of change in IOP/ml volume was achieved with simultaneous change in exophthalmometry of <0.5 mm change/ml added volume, indicating an acceleration in pressure in the face of a steady volume. This criteria was met for 11 of 12 orbits. The 12th orbit missed this threshold by 1 mm Hg in IOP. P LOC occurred at an average IOP of 43.0 mm Hg (±5.8 mm Hg, 90% CI) and after an average injection of 13 ml (±1.4 mm, 90% CI). Additionally, lateral cantholysis, superior septolysis, and inferior septolysis were statistically equivalent in reducing IOP after P LOC . IOP and orbital compartment pressure are excellent proxies for each other in the authors' model. Orbital compliance is a mathematic phenomenon that can be quantified, as evident in this investigation. P LOC can inform timing for orbital decompressions in the presence of heightened IOP. Multiple procedures can be used to extinguish dangerously high orbital compartment pressure.

PATELLAR DISLOCATION AND PATELLAR INSTABILITY PANORAMIC REVIEW

Introduction: Primary patellar dislocation is usually the initial manifestation of patellofemoral instability. Among the long-term repercussions of this disorder are recurrent dislocation and indefinable knee dysfunction. At present, there is no agreement on the optimal treatment of patellar dislocation. Objective: to detail the current information related to patellar dislocation, epidemiology, mechanism of action, clinical evaluation, imaging evaluation, classification, differential diagnosis, treatment and complications of the disease. Methodology: a total of 30 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 22 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: patella, knee anatomy, patellar dislocation, knee instability. Results: Approximately 5% of the time it is related to osteochondral fractures. To define whether a patella is high or low, a lateral radiograph should be taken with the knee in 30° of flexion to determine Blumensaats line. The increase in the Q angle facilitates patellar dislocation. Most patellar dislocations are related to congenital anomalies of the patella or trochlea, high patella, hypoplasia of the vastus medialis and hypertrophy of the lateral retinaculum. Conclusions: Patellar dislocation is usual in individuals with connective tissue disorders and hypermobility, the patella can be dislocated laterally, superiorly or intra-articularly, presenting different mechanisms of action for each case. It is important to have a good knowledge of the anatomy and to measure the Q angle because the increase of this angle facilitates patellar dislocation. It is essential to establish the etiology of the dislocation, especially in those with recurrent dislocations as this may alter the management plan. In addition to the clinical evaluation it is important to request anteroposterior, lateral knee and axial projections. When conservative treatment is chosen, reduction and immobilization with a cast or orthosis should be performed with the knee in extension, the long knee brace can be used, with or without arthrocentesis to relieve the symptomatology; surgical treatment is mostly used in recurrent dislocations. At the moment, no surgical technique is able to correct all the problems of patellar alignment. It should be kept in mind that the surgical procedure should take into account the individuals age, diagnosis, activity level and the situation of the patellofemoral joint. Patellofemoral instability should be treated with the goal of correcting all of the alignment issues. The usual complications are loss of knee mobility, recurrent dislocation and patellofemoral pain. KEY WORDS: dislocation, patella, knee, instability.

Positioning of pivot points in quadrupedal locomotion: limbs global dynamics in four different dog breeds.

Dogs (Canis familiaris) prefer the walk at lower speeds and the more economical trot at speeds ranging from 0.5 Fr up to 3 Fr. Important works have helped to understand these gaits at the levels of the center of mass, joint mechanics, and muscular control. However, less is known about the global dynamics for limbs and if these are gait or breed-specific. For walk and trot, we analyzed dogs' global dynamics, based on motion capture and single leg kinetic data, recorded from treadmill locomotion of French Bulldog (N = 4), Whippet (N = 5), Malinois (N = 4), and Beagle (N = 5). Dogs' pelvic and thoracic axial leg functions combined compliance with leg lengthening. Thoracic limbs were stiffer than the pelvic limbs and absorbed energy in the scapulothoracic joint. Dogs' ground reaction forces (GRF) formed two virtual pivot points (VPP) during walk and trot each. One emerged for the thoracic (fore) limbs (VPPTL) and is roughly located above and caudally to the scapulothoracic joint. The second is located roughly above and cranially to the hip joint (VPPPL). The positions of VPPs and the patterns of the limbs' axial and tangential projections of the GRF were gaits but not always breeds-related. When they existed, breed-related changes were mainly exposed by the French Bulldog. During trot, positions of the VPPs tended to be closer to the hip joint or the scapulothoracic joint, and variability between and within breeds lessened compared to walk. In some dogs, VPPPL was located below the pelvis during trot. Further analyses revealed that leg length and not breed may better explain differences in the vertical position of VPPTL or the horizontal position of VPPPL. The vertical position of VPPPL was only influenced by gait, while the horizontal position of VPPTL was not breed or gait-related. Accordingly, torque profiles in the scapulothoracic joint were likely between breeds while hip torque profiles were size-related. In dogs, gait and leg length are likely the main VPPs positions' predictors. Thus, variations of VPP positions may follow a reduction of limb work. Stability issues need to be addressed in further studies.

A novel assessment method to identifying the interaction between adjacent corrosion defects and its effect on the burst capacity of pipelines

This work provides a new systematic evaluation method to assess the interaction between adjacent corrosion defects and its effect on the integrity of pipelines. First, a finite element (FE) model of a pipeline containing adjacent defects (defects in longitudinal, circumferential and diagonal alignments) was developed. Then, the detailed relationships between defect spacing, and geometry, as well as the burst pressure of the pipe were investigated. At last, an interaction identification criterion applicable to asymmetrical defects was proposed, whose accuracy and reliability of the criterion were validated by FE simulations. The results show that the arrangement of corrosion affects the effect of interaction between adjacent defects. Regarding defects in longitudinal and circumferential alignments and with different depths, the increase of defect spacing strengthens the interaction between defects. For diagonally and circumferentially aligned defects with an identical depth, interaction strength tends to decrease first and then increase with the rise of defect spacing. An increase in defect depth exacerbates the interaction between adjacent corrosions. Similarly, an increase in the length of the shorter defect enhances the interplay between defects, which thus reduces the burst capacity of the pipe. When the length of the longer defect in adjacent defects increases, the interaction between the defects will be weakened, and the burst pressure of the pipeline is mainly dominated by the longer defect. Diagonally aligned defects show the strongest interaction effect when their overlapped distance in axial projection equals the sum of depths of adjacent defects, followed by defects in a longitudinal alignment. Besides, defects in a circumferential alignment have little effect on the failure pressure of the pipe. It is expected that the proposed interaction assessment criterion for adjacent defects with different arrangement types can provide a reference for assessing the integrity of pipelines with cluster corrosion defects.

CALCANEAL FRACTURE, EPIDEMIOLOGY, ANATOMY, MECHANISM OF INJURY, CLASSIFICATION, IMAGING PRESENTATION, CLINICAL PRESENTATION, MANAGEMENT AND COMPLICATIONS

Introduction: Throughout time, calcaneal burst fractures have been referred to as lovers fractures because the injury occurred when a suitor jumped off a lovers balcony to avoid detection. The calcaneus is part of the 7 tarsal bones, calcaneus, talus, cuboid, navicular, first, second and third cuneiform. Calcaneal fractures are infrequent, however, they have a high potential to weaken the limb. Objective: to detail current information related to calcaneal fractures, epidemiology, anatomy, mechanism of injury, clinical evaluation, imaging evaluation, classification, treatment and complications. Methodology: a total of 30 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 21 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: calcaneal fracture, calcaneus, calcaneal osteosynthesis, foot fractures. Results: The calcaneus is the most commonly fractured tarsal bone, representing 2% of all fractures. Calcaneal fractures are bilateral in 5 to 10%, and are usually related to fractures of the lumbar spine and other fractures of the lower limb caused by high-impact trauma. About 10 % of calcaneal fractures are open. Conclusions: The calcaneus is the most commonly fractured tarsal bone, accounting for 2 % of all fractures. Calcaneal fractures are bilateral in 5 to 10% and are usually related to fractures of the lumbar spine and other fractures of the lower limb caused by high impact trauma. About 10% of calcaneal fractures are open, and neurovascular injuries are infrequent in calcaneal fractures. Calcaneal fractures are more related to high energy impacts that generate axial loading of the bone, however they can occur with any injury to the foot and ankle. The main characteristics of individuals affected with a calcaneal fracture are pain, swelling, widening, deformity, ecchymosis and functional impotence. To make the radiological diagnosis of calcaneal fracture in the first instance it is recommended to request an anteroposterior projection of the foot, lateral projection of the rearfoot, Harris axial projection and an ankle series; if necessary, a computed tomography can be performed. In practice, calcaneal fractures can be classified as intra-articular or thalamic and extra-articular; in addition, classification systems such as Sanders and Essex-Lopresti are used. Treatment is controversial. Even with adequate reduction and management, calcaneal fractures can become extremely disabling injuries, presenting a mutable prognosis with various types of functional limitation and pain. Currently, some factors have been found to be related to better outcomes, however, the literature comparing various methods of surgical versus conservative treatment show that surgical management has increased complication rates, however, it may lead to optimal functional outcomes in some individuals. Generally, the incidence of complications of calcaneal fractures is high and increases the worse the wound. Among the most common are calcaneal osteomyelitis, post-traumatic osteoarthritis, wound dehiscence, increased heel width, loss of subtalar mobility, chronic peroneal tendonitis, and complex regional pain syndrome. KEY WORDS: fracture, calcaneus, osteosynthesis, foot.

CLINICAL AND RADIOLOGICAL OUTCOMES OF CUSTOM 3D-PRINTED GLENOID COMPONENTS IN PRIMARY AND REVISION REVERSE POLARITY TOTAL SHOULDER ARTHROPLASTY WITH SEVERE GLENOID BONE LOSS: A MINIMUM TWO-YEAR FOLLOW-UP

The purpose of this study is to report the clinical and radiological outcomes of patients undergoing primary or revision reverse total shoulder arthroplasty using custom 3D printed components to manage severe glenoid bone loss with a minimum of 2-year follow-up.After ethical approval (reference: 17/YH/0318), patients were identified and invited to participate in this observational study. Inclusion criteria included: 1) severe glenoid bone loss necessitating the need for custom implants; 2) patients with definitive glenoid and humeral components implanted more than 2 years prior; 3) ability to comply with patient reported outcome questionnaires. After seeking consent, included patients underwent clinical assessment utilising the Oxford Shoulder Score (OSS), Constant-Murley score, American Shoulder and Elbow Society Score (ASES), and quick Disabilities of the Arm, Shoulder, and Hand Score (quickDASH). Radiographic assessment included AP and axial projections. Patients were invited to attend a CT scan to confirm osseointegration. Statistical analysis utilised included descriptive statistics (mean and standard deviation) and paired t test for parametric data.3 patients had revision surgery prior to the 2-year follow-up. Of these, 2/3 retained their custom glenoid components. 4 patients declined to participate. 5 patients were deceased at the time of commencement of the study. 21 patients were included in this analysis. The mean follow-up was 36.1 months from surgery (range 22–60.2 months). OSS improved from a mean 16 (SD 9.1) to 36 (SD 11.5) (p &lt; 0.001). Constant-Murley score improved from mean 9 (SD 9.2) to 50 (SD 16.4) (p &lt; 0.001). QuickDASH improved from mean 67 (SD 24) to 26 (SD 27.2) (p = 0.004). ASES improved from mean 28 (SD 24.8) to 70 (SD 23.9) (p = 0.007). Radiographic evaluation demonstrated good osseointegration in all 21 included patients.The utility of custom 3D-printed components for managing severe glenoid bone loss in primary and revision reverse total shoulder arthroplasty yields significant clinical improvements in this complex patient cohort.

Application of the pedicle axis view in percutaneous screw placement for type III fracture dislocation of the sacroiliac joint

AimTo investigate the clinical application of axial view projection of the pedicle in percutaneous screw placement for type III fracture dislocation of the sacroiliac joint.MethodsPercutaneous sacroiliac screw fixation was performed in 29 patients with type III sacroiliac joint fractures under X-ray fluoroscopy (C-arm) using axial view projection of the pedicle after preoperative traction reduction and preoperative preparation. The study included 19 males and 10 females, aged 20 to 75 years old, with a mean age of 42.1 ± 3.4 years.ResultsThe total operative time ranged between 44 and 135 min, with a mean of 95.5 ± 9.4 min. The intraoperative fluoroscopy time ranged between 15 and 42 s, with a mean of 25 ± 4.7 s. The intraoperative blood loss ranged between 5 and 10 ml, with a mean of 7.1 ± 1.3 ml. According to the Matta scoring system, excellent outcomes were achieved in 25 cases, whereas good outcomes were achieved in 4 cases. Based on the definition by Neo et al., pedicle screw positions were categorized into four grades: grade 0 (33 screws), grade I (2 screws), grade II (2 screws), and grade III (0 screws). Excellent outcomes were achieved in 94.6% of Grade 0 and I screws. According to Majeed’s functional score, 21 cases achieved excellent outcomes, whereas 8 cases achieved good outcomes. The 29 patients were followed between 3 and 18 months, with a mean of 7.1 ± 1.2 months. All patients achieved anatomical reduction with accurate screw placement and successful healing of their fractures, with no cases of bone penetration or neurovascular injury.ConclusionAxial view imaging of the pedicle using fluoroscopy is a convenient and rapid fluoroscopy method for percutaneous screw placement for type III fracture dislocation of the sacroiliac joint, with a high rate of success, good safety, and short fluoroscopy time.

PERBEDAAN PROYEKSI PEMERIKSAAN RADIOGRAFI SINUS PARANASAL PADA KLINIS SINUSITIS DI RUMAH SAKIT MAYAPADA LEBAK BULUS.

Radiographic examination of the paranasal sinuses using an X-ray machine can be performed with various projections. Selection of the right projection will provide imaging results that support the diagnosis process. This study aims to analyze the management of the radiographic examination of the paranasal sinuses and to analyze the use of X-ray projections for the examination of the paranasal sinuses in patients with clinical sinusitis at Mayapada Hospital Lebak Bulus. This research method is descriptive qualitative with secondary data analysis approach in January 2022. The study sample consisted of six patients who underwent examination of the paranasal sinuses with clinical sinusitis. The research process includes literature study, observation and interviews. The instruments used are worksheets and documentation tools. Interviews were conducted with two radiographers and one radiology specialist. The result of this research is that the examination of the paranasal sinuses in clinical sinusitis can be performed using two or three projections. Examination of two projections, consisting of a parietoacanthial projection (water's method open mouth) and a lateral projection. Three-projection examination consists of lateral projection, parietoacanthial projection (water's method open mouth) and Posteroanterior or PA axial projection (caldwell method). &#x0D;